The PBEye

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Opioids are a class of drugs used to reduce pain, ranging from prescription opioids such as oxycodone and morphine, to illegal opioids such as heroin. In the 1990s, healthcare providers began prescribing opioid pain relievers at increased rates, leading to the widespread misuse of prescription and non-prescription opioids. This resulted in a spike in addiction, amounting to 350,000 deaths between 1999 and 2016 from an overdose involving opioids. In 2017, the Health and Human Services (HHS) Acting Secretary declared a public health emergency to address this epidemic.

Because of the alarming number of overdoses, efforts to mitigate the epidemic tend to focus on supporting healthcare providers, raising awareness about opioid misuse, and encouraging safe choices among consumers. While valuable, these endeavors bypass many of the immediate challenges faced by those suffering from addiction throughout the recovery process, as well as by their close friends and family members. As legal problems often go hand-in-hand with the slew of effects stemming from opioid addiction, there is an opening for pro bono attorneys to help combat the crisis and improve people’s lives.

Some of the legal challenges confronted by people suffering from opioid addictions include:

Establishing or maintaining guardianships and other child custody issues;

Obtaining driver’s licenses, which are often suspended for non-driving-related reasons; and

Other post-incarceration barriers to re-entry.

People addicted to opioids and recovering from addiction are likely to encounter at least one – if not several – of these obstacles. The consequential hardships also affect friends and family, and result in accumulated burdens on the judicial system, healthcare centers, foster care system, and more. A multi-pronged approach is, therefore, needed to address the varying demands of the community.

Medical-Legal Partnerships as an Innovative Solution

Medical-legal partnerships (MLPs) offer a practical continuum of legal assistance and support throughout the recovery process. MLPs are collaborative arrangements between legal professionals and healthcare organizations where attorneys are available on-site to assist eligible patients with needs that would otherwise not be addressed within the clinical setting. Over 300 health care organizations operate MLPs, with more currently in the planning stage. Therefore they are an established model that can be leveraged to provide more holistic services.

A best practice is for patients to be screened for legal needs and referred for legal assistance as soon as they are admitted for opioid addiction treatment. Pro bono attorneys can help train medical professionals to identify common legal problems, while doctors can train attorneys and legal staff so that they better understand addiction and the recovery process. One optimal aspect of these partnerships is that pro bono attorneys reach out to patients, rather than the other way around, so attorneys assist patients with their specific needs and offer tailored solutions. This establishes a more client-centered process, one that is difficult to attain when performing discrete functions where clients contact attorneys for help with a specific matter.

Through MLPs, pro bono attorneys are meaningfully involved in patients’ lives, as they work with medical staff to understand specific treatment plans and other personal information. This allows attorneys to better advocate for patients, particularly before those who have misconceptions about treatment for addiction. Attorneys can successfully explain that treatment plans are medical decisions made by doctors, not by judges. For example, one patient was pressured by a judge to wean off her treatment program, which combined therapy with replacement opioids to prevent withdrawal, because the judge viewed it as replacing one addiction with another. An MLP attorney informed the judge that ending treatment is a medical decision to be made solely by a doctor and argued that the patient’s recovery depended on the specific treatment plan. Ultimately, the judge changed her mind and allowed treatment to continue.

Employment is also an important area where pro bono attorneys can be of help. Patients may not realize that barriers to future employment have legal solutions, or that termination from their job could be illegal. For instance, one employee tested positive for methadone, a prescribed replacement opioid, and her employer moved to terminate her. An MLP attorney informed the employer that they cannot not fire an employee for receiving legitimate medical treatment. Increasing opportunities for employment does not end with advocating for treatment plans; assisting in other areas, such as helping to seal criminal records will open doors for future opportunities as well.

Both testimonials and research studies reveal the benefits of embedding legal assistance in medical facilities, particularly in settings like treatment centers, where patients have complicated legal histories. While MLPs have been in place for several decades, they have only recently begun focusing on substance use disorders (SUDs). As of September 2017, only four MLPs (located in Cincinnati, Ohio; Indianapolis, Indiana; Portsmouth, Ohio; and Reno, Nevada) in the U.S. specifically focused on helping people with SUDs. While many partnerships with hospitals, health systems, and health centers exist across the U.S., pro bono work can continue to expand in this area with a focus on opioid addiction.

Diversion Programs as an Effective Tool for Recovery

Diversion programs, another experimental method of aiding recovery, mitigate the current mass incarceration problem in the United States and provide better resources to those battling addiction. Many different types of diversion programs exist; for example, drug courts act as alternatives to incarceration, where participants are transferred after pleading guilty to a drug-related crime. Through other diversion programs, participants are diverted at the point of arrest and enter the program instead of being charged with a crime. The average national completion rate for treatment courts is 60 percent, approximately two-thirds higher than probation.

One such experimental court, the Opiate Crisis Intervention Court, is a judicially supervised triage program in Buffalo, New York that links participants with medication and behavioral treatments within hours of their arrest. Drug court participants have biweekly appearances before a judge, and they receive medication and residential treatment if needed, as well as random drug testing and other social services. They are incentivized with rewards, including the reduction of court costs and gift cards.

These courts offer meaningful opportunities for pro bono attorneys to play a direct role in someone’s life. Drug court teams are typically comprised of a drug court judge, a prosecuting attorney, a defense attorney, a probation officer, treatment representatives, and a law enforcement representative. While the judge makes final determinations regarding a range of consequences, such as reduced supervision requirements, transfers to more intensive levels of care, or punitive sanctions, the drug court team meets in a collaborative setting to review each case and contribute information about participants’ progress. Because of individualized treatment plans and clinical needs, pro bono attorneys are able to advocate for patients by explaining specific information that may otherwise go unnoticed by the rest of the team. Whether it is through working in a drug court as part of a team, advocating for the expansion of similar programs, or helping funnel people into treatment centers early in the process, providing access to an attorney and representation is crucial in assisting recovering addicts.

Potential Pro Bono Opportunities

Attorneys have a unique ability to support people addicted to opioids – as well as their families – in substantial capacities. The range of pro bono opportunities is broad and deep, with options for both small and large-scale projects and those that would appeal to litigators and transactional lawyers. Options for meaningful pro bono work include, but are not limited to:

Helping administer advice clinics run by legal services providers by offering guidance to those experience addiction, as well as to their families and to the community. Pro bono attorneys would help people identify common legal problems and provide resources to those who need individualized advice;

Working with a public defender’s office, representing people recovering from addiction and advocating for their individualized needs;

Working with a prosecutor’s office, figuring out the best program for people recently arrested due to opioid-related crimes while aiming to divert them from the criminal justice system into diversion programs;

Filing lawsuits against pharmaceutical companies on behalf of states, cities, legal organizations, and citizens affected by the opioid crisis, or writing amicus briefs in support of these lawsuits (subject to business and other conflicts);

Helping grandparents and children whose parents are addicted to opioids or recovering from addiction by partnering with children’s hospitals, foster homes, or schools; and

Assisting nonprofits that provide services to people affected by the opioid crisis with a variety of transactional matters, ranging from compliance with laws and regulations to advice regarding government grants and contracts.

Combatting fraudulent treatment and recovery centers.

Conclusion

Much of the conversation surrounding the opioid crisis focuses on overdose-reversal drugs, medication-assisted treatment, and best policies for decreasing the number of people addicted to opioids. Sometimes, the “very basic things that could go a long way to accessing treatment and maintaining recovery” are forgotten. It is difficult for low-income patients to successfully recover if they don’t have basic necessities, such as housing, education, childcare, employment, or transportation, or if they face significant legal barriers to obtaining these necessities. Fulfilling these basic needs can be daunting on one’s own, and it is an area where pro bono attorneys can make a vast difference in someone’s life. There is an opportunity to suit the interests and talents of every pro bono lawyer.

How should we treat our pro bono hours? Traditionally, as an incentive and motivator for attorneys to participate in pro bono, the gold standard was for law firms to treat time spent on pro bono matters the same as time spent on billable matters. At firms with billable hour requirements, pro bono matters would count towards reaching hourly goals. However, we have recently seen a trend of firms of moving away from the billable hour as a tool to evaluate performance of attorneys by either minimizing their importance or doing away with billable hours altogether. For firms that are distancing themselves from this traditional practice, what other ways are there to engage and encourage their attorneys to do pro bono work?

Firm Culture and Messaging

Reaffirming the firm’s commitment and dedication to pro bono is a meaningful tool to engage attorneys. In addition to writing and speaking about the importance of pro bono and access to justice, it is critical that firm leaders visibly participate in pro bono in order to set an example and be positive role models.

Goals and Benchmarks

Firms should consider including pro bono participation in their professional milestones and benchmarks, especially as they transition from billable hours. Attorneys may find it difficult to adapt to more abstract evaluation methods when they can no longer quantify performance with objective means, such as billable hours. Requiring attorneys to set a pro bono goal to work towards provides a clear, concrete, and achievable aspiration. In addition, when attorneys are self-identifying performance areas for improvement, pro bono may be able to strategically fill identified gaps and help develop targeted skills and core competencies.

Supervision and Reviews

Attorney evaluations and reviews are critical measures of performance beyond objective hour requirements. Rigorous and constructive feedback ensures a high-quality work product while presenting opportunities for attorneys to receive credit and recognition for their work. Additionally, attorneys can evaluate their own performance based on the constructive comments they receive. Consider using pro bono professional staff and other pro bono leaders in the review process if they have knowledge of the attorney’s work. Self-evaluations should include questions about pro bono as well. These tactics allow attorneys to think deeply about their own performance, including their pro bono involvement, and how they are measuring up.

Metrics

There are alternative methods for quantifying pro bono work beyond using billable hours as a measuring tool. Rather than counting hours, firms could set a record number of pro bono matters or encourage attorneys to devote a certain percentage of their time to pro bono. Law Firm Pro Bono Challenge ® signatories commit to contribute either 3 or 5 percent of their billable time to pro bono work. By joining the Challenge, your firm can institutionalize its firm-wide commitment to providing pro bono legal services to low-income and disadvantaged individuals and the organizations that serve them. To learn how your firm can become a leader in law firm pro bono, please contact us.

The Law Firm Pro Bono Project is available to provided tailored assistance to firms in addressing these and other questions related to law firm pro bono. Please contact Elysse DeRita to schedule a confidential consultation or if you have any questions.

*Hat tip to PBI intern Madeline Jenks for her assistance with this post.

A recent Stanford University-led study found that a majority of adults over the age of 50 highly value “prosocial” behaviors, actions that are positive, caring, helpful and of benefit to others. The study also found that one third of older adults exhibit a need for a purpose that is beyond themselves. This one-third equates to more than 34 million people who dedicate their time to addressing the needs of others and making the world a better place. As a benefit, those who engage in prosocial behaviors reported a more positive outlook on life and positive effects on health.

Like the Stanford’s study, Pro Bono Institute perceived the need arising for boomers to get involved in prosocial activity. Pro bono work would address unmet needs for legal representation and also be personally fulfilling and meaningful to late-career attorneys. Law firms are particularly appropriate structural allies for facilitating their experienced lawyers’ participation as they step down from full-time firm responsibilities to expanded pro bono activities, either as continuing members of the firm or as firm-supported alumni working primarily with legal services organizations.

In 2005, the Pro Bono Institute launched our Second Acts® project, an innovative initiative, in partnership with our core constituencies of major law firms, in-house legal departments, and public interest organizations, to support transitioning and retired lawyers who are interested in second volunteer careers in public interest law. Late-career attorneys have a wealth of skills, knowledge, and experience that, when utilized, can have a sizable impact on economic and social justice. Helping firms to create transition pathways and policies that fit within their institutional culture can have a variety of benefits, including improving the firm’s overall pro bono program; enhancing loyalty and firm reputation both internally and externally; offering increased mentoring, supervision, and training for junior attorneys; and providing a mechanism for balancing staffing levels and minimizing disruptions. Recently, we updated our original research about how firm’s incentivize their late-career attorneys to do pro bono work. We found that since our 2006 research, the number of firms reporting having Second Acts program® has doubled. These firms reported making a wide-range of support available to senior/transitioning attorneys to perform pro bono work.

Additionally, we found that over half of the respondents from firms without Second Acts® programs are interested in implementing such an initiative. Fifty-six percent of firms without programs indicated that such a program would increase overall pro bono performance, hours, and impact.

With adequate training and support, late-career lawyers would not only bring a major increase in pro bono capacity, but also expertise, leadership, moral support, and new perspectives that would be of great benefit. The Law Firm Pro Bono Project is available to provide tailored assistance to firms in addressing these and other questions related to Second Acts® and late-career lawyers. Please contact Elysse DeRita to schedule a confidential consultation or if you have any questions.

Has your firm or organization implemented a Second Acts® initiative to engage transitioning and retired attorneys in meaningful pro bono work? Leave a comment to share your experience.

We also looked at average pro bono hours per attorney and attorney participation rates by firm size:

We are thankful to all signatories, regardless of headcount, for their service and pro bono leadership.

To learn more about the state of law firm pro bono, check out the complete Challenge Report, including analysis of the data, detailed graphs, and more. Also, tune in to the Law Firm Project’s discussion of the Report and Pro Bono: Beyond the Numbers on its podcast, the Pro Bono Happy Hour. If your firm of 50 or more lawyers would like to join the Challenge and become visible pro bono leaders, please contact Law Firm Pro Bono Project Assistant Elysse DeRita.

As we start this patriotic holiday week, do you need a break from thinking about the state of our union? How about focusing instead on the state of pro bono? Don’t miss the latest episode of the Law Firm Pro Bono Project’s podcast, the Pro Bono Happy Hour, Pro Bono: Beyond the Numbers, during which we discuss the recently published 2016 Law Firm Pro Bono Challenge® Report, the current pro bono landscape, concrete and doable tips for improvement and growth, and more.

Subscribe to the Pro Bono Happy Hour on Apple Podcasts and be sure to leave a review! We’d appreciate the feedback and it would help us expand the conversation about access to justice. The podcast is also available on YouTube. Links to all of our episodes can be found here.

Listen along and let us know what you think. Send your comments, thoughts, feedback, questions, and suggestions to probono@probonoinst.org. Be warned: we might just read them on the air.

A notable highlight from 2016 was the jump in charitable giving to legal services organizations. The average firm donation last year was $503,875, the highest average donation in the Challenge’s history, and a 9.4% increase over 2015, when the average donation per firm was reported as $460,660.

We applaud those firms and attorneys who not only gave their time but also contributed dollars to local and other legal services organizations. Firm contributions are critical to maintaining an effective pipeline and support network for legal services programs, and, in return for law firm pro bono efforts. They, however, on their own absent government and other support, will never comprise full funding for legal services. Now more than ever before, we must remain vigilant and fully engaged in the fight for government funding for civil legal aid for the poor.

Check outthe complete Challenge Report, including analysis of the data, l information regarding firm size and pro bono, detailed graphs, and more. Watch this space for more highlights from this year’s Challenge Report, and tune into to the Law Firm Project’s discussion of the Report and the “State of Pro Bono” on our podcast, the Pro Bono Happy Hour.

If your firm of 50 or more lawyers would like to join the Challenge, please contact Law Firm Pro Bono Project Assistant Elysse DeRita.

This March, CPBO releases the latest installment in its infographic series, aimed at making complicated in-house pro bono issues easier to digest. The newly published infographic is titled “In-House Pro Bono Budgets”. The new publication touches on: expenses, budgeting, and foundation funding. The data comes from not-yet-released responses to the 2016 CPBO Benchmarking Survey.

Among other statistics, the infographic reveals that the largest expenses covered in annual budgets include trainings of volunteers and refreshments at events. In addition, 50% of respondents whose pro bono programs received support from the company’s foundation or CSR department report in 2015 they received more than $100,000.

Want to know about more than just budgets? Good news, CPBO has developed a wide variety of resources for legal departments of any size, including the following infographics on critical in-house pro bono issues:

After a food-filled holiday season, many of us begin the New Year with health-related resolutions. Want to learn more about pro bono efforts designed to fight hunger and increase access to nutritious food for those in need? While eating is on our minds, check out the Law Firm Pro Bono Project’s publication, Pro Bono Food for Thought: Improving Access to Nutrition.

Pro bono efforts designed to support food access and security have the potential to transform a community. Examples include turning an abandoned lot into a productive urban farm and eliminating bureaucratic barriers obstructing food stamp distribution or access to school meal programs. Because this is an emerging area that many people – not just foodies – feel especially passionate about, you may be able to excite and meaningfully engage your attorneys and professional staff, including some who may not have previously been active pro bono participants.

Voting is at the heart of our democracy, yet our voting system remains deeply flawed. A number of prominent civil rights and public interest groups are leading non-partisan efforts to ensure that every eligible voter can vote and that every proper vote is counted.

Pro bono lawyers are often at the forefront of legal efforts to cure legal flaws in the system, which threaten the accuracy, legitimacy, and fairness of the voting process. Lawyers have important roles to play at all levels of the election protection and reform processes – crafting legislation, enforcing voting laws, researching legal developments, monitoring the election process for unlawful behavior, representing eligible individual voters, and aiding local, state, and national organizations in bringing impact litigation to challenge unconstitutional election laws. The range of pro bono opportunities is broad and deep, with meaningful options for both small and large-scale projects and those that would appeal to litigators and non-litigators.

Want to get involved and make a difference this election year? PBI has three new resources to help you navigate election-related pro bono opportunities:

Join us Thursday, May 5 at 12:00 p.m. ET for “Global Due Diligence Manual” a one-hour program hosted in conjunction with West LegalEdCenter.

PBI’s new Global Due Diligence Manual, produced in partnership with several global law firms, is a hands-on guide intended to help you locate, vet, and take on global pro bono opportunities. Join us for a discussion of clearinghouses, major NGO clients, research projects, and more. Learn how the Manual can help you expand your global pro bono program.

Confirmed Speakers:

Wendy Atrokhov, Latham & Watkins*†

Lisa Dewey, DLA Piper *†

Lou O’Neill, White & Case*†

Interested in-house counsel should contact CPBO Project Assistant Virginia Lyon for registration information or to submit questions in advance of the program. Registration is free for Law Firm Pro Bono Project Member Firms. Law firm participants should contact Law Firm Pro Bono Project Assistant Eva Richardson for registration information.

Schedule conflict? Don’t worry – the program will also be available on-demand shortly after the original broadcast date.

* denotes a Signatory to the Law Firm Pro Bono Challenge®† denotes a Member of the Law Firm Pro Bono Project** denotes a Signatory to the Corporate Pro Bono Challenge®